Case Talk:Chukalu
January 14, 2007, Update (Week 2) Thus far I'm very pleased with how Chu is doing on TR. The litter box doesn't have huge clumps in it now and she's no longer sporadically obsessed with water. Her coat seems even softer and she is in a very good and playful mood most of the time. My husband summed it up by commenting, "Chu seems very happy." For some reason, Chu's response to the PZI seems to have flattened out a little in the second week -- well, her graph for week 2 is not flat by any means, but the spikes are definitely lower than they were. There have been a couple days where she's received more insulin than I ever thought she'd get, but all with positive results. That took some adjustment on my part because for years she got no more than 1.5 units twice a day. This week she is not going as high as she used to, nor as low as she did last week. Less drastic BG swings are definitely a good thing in my opinion; I will just need to work on moving it down the scale overall. I'm also going to try a new strategy with feeding: no food if her BG tests over 160. The problem is that as her BG levels go higher, her hunger level increases. If she eats, the resulting food spike then compounds the high BG level. So if she's at or below 160 and on a downward trend, she'll be able to free feed on wet food. If she's at or above 160 and on an upward trend, food will be picked up, insulin administered and food then put back down after the BG is in a good range. My thinking is that when her BG levels are in normal ranges (under 150) she only eats in response to actual hunger but most of her eating at hyperglycemic levels is in response to the fact that her system can't access the glucose she already has in her blood and it thinks she needs to eat more when she really needs more insulin, not more sugar. Of course if it looks like she's not getting enough to eat with this approach I'll have to give her some food at high levels so she doesn't get too hungry, and maintains her weight but we'll see how it goes. --Kellie & Chu 18:03, 14 January 2007 (UTC) January 23, 2007, Update (Week 3) Overall Chu's blood glucose levels are much lower than they were the first two weeks, with occasional spikes into the mid-200's. She is quite happy on this protocol and has lots of energy when she wants to play but she also seems sleepy a lot of the time. Maybe she's just always slept this much and I haven't been as attentive to it. It's also possible that her pancreas is trying to heal now that she has good BG levels most of the time and that might be tiring. I have become hyper-vigilant about monitoring her since we started tight regulation just because I still worry that she might have an issue with really low glucose levels, though I haven't yet noticed any problems. There have been a few instances where at about 10-14 hours after her shot her BG dips down a bit -- seemingly on its own. I'm still not sure if this is pancreatic activity or if it is due to her insulin still going toward peak effectiveness after her food has been digested. Hopefully it's the former. --Kellie & Chu 19:39, 23 January 2007 (UTC) No food over 160 idea A point to consider: maybe alter that to "no food if over 160 and AFTER peak time". Before peak, the additional insulin action might be able to handle more food. In fact, you might even want, for now, to reduce or remove all food after the insulin has finished peaking, and wait until next shot to feed again. I can see that this will be hard to define since you are tracking 3 shots at once, so maybe just think about the peak of the latest shot... --Steve and Jock that might be easier... ...than the way I was trying to do it. You think it would work if I just make sure she has food from the time her insulin usually kicks in (which is 2-3 hours post shot) until I see the numbers headed back up? I did pick her food up last night after I saw she was on an upswing. I think that plus the small dose I gave to hold her over until morning really helped. She seems to has a habit of early morning eating (4-6am) when I leave food down that usually cause her BGs to be high by the time I wake up. --Kellie & Chu 19:35, 25 January 2007 (UTC) Week 5 update We seem to have taken a step backwards this week. Her average bg is quite a bit higher than it was the week before. I think the most likely reason is that we have introduced a new cat, Tonka, into the house. Chu has been a little stressed about it, so hopefully that's the only cause for the increase and things will settle back down soon. Week 7 update After week 4 Chu wasn't experiencing the same results as before. I'm hoping that this might be due to a problem with the insulin and have started her on a new vial of PZI Vet as of 2/21/07. If it was the insulin week 8 should be much better. --Kellie & Chu 20:43, 22 February 2007 (UTC)